Healthcare Provider Details
I. General information
NPI: 1023787629
Provider Name (Legal Business Name): TENNESSEE OSTEOPATHIC INSTITUTE, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/08/2021
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 S CONCORD ST STE 102
KNOXVILLE TN
37919-3339
US
IV. Provider business mailing address
601 S CONCORD ST STE 102
KNOXVILLE TN
37919-3339
US
V. Phone/Fax
- Phone: 865-440-8759
- Fax:
- Phone: 865-440-8759
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 204D00000X |
| Taxonomy | Neuromusculoskeletal Medicine & OMM Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
C
COPPINGER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 865-440-8759